Plasma renin activity following renal transplantation

Snow, Michael; Jachuck, S J; Robson, V.; Wilkinson, Robert W.

doi:10.1136/pgmj.54.631.311

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…This time course follows the new kidney graft resuming function and the resultant elevated renin levels in the immediate post-transplant period. 26 , 27 …”

Section: Discussionmentioning

confidence: 99%

The perioperative management of simultaneous bilateral nephrectomy with renal transplantation: a case series

Höfer

Kor

Prieto

et al. 2021

Can J Anesth/J Can Anesth

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Purpose Bilateral nephrectomy is performed at times with renal transplantation. Though surgical indications and timing of these two procedures have been described, there are no large case series describing the anesthetic management of these cases. We sought to describe our experience. Methods We performed a historical cohort study on 54 consecutive cases of simultaneous bilateral nephrectomy with renal transplantation at a single, tertiary-care medical centre. Descriptive statistics were used. Results The most common etiology of kidney disease involved was autosomal dominant polycystic kidney disease at 52/54 (96%) cases. All patients received grafts from living donors. An arterial line was placed in 44 (81%) and a central venous catheter in 16 (30%) subjects. At least one vasopressor infusion was used in 44 (81%) cases and 37 (69%) patients required admission to the intensive care unit (ICU). Of this subset, 30 (81%) were admitted for ongoing vasopressor support and six (16%) for hemodynamic monitoring. All patients were extubated in the operating room upon completion of the procedure. Median [interquartile range (IQR)] ICU length of stay (LOS) was 0.9 [0.7–1.4] days and total hospital LOS was 4.4 [4.3–5.4] days. There were no cases of mortality at 30 days or of postoperative dialysis. Conclusions Adult patients undergoing simultaneous bilateral nephrectomy with renal transplantation often developed perioperative hypotension requiring vasopressor infusions and postoperative transfer to the ICU. This is possibly due to a temporary loss of the renin-angiotensin system. Despite this, patients most commonly were transferred to the floor on postoperative day 1 and had successful outcomes with no mortality at 30 days.

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“…This time course follows the new kidney graft resuming function and the resultant elevated renin levels in the immediate post-transplant period. 26 , 27 …”

Section: Discussionmentioning

confidence: 99%

The perioperative management of simultaneous bilateral nephrectomy with renal transplantation: a case series

Höfer

Kor

Prieto

et al. 2021

Can J Anesth/J Can Anesth

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Hypertension Following Renal Transplantation

Wilkinson¹

1988

Management of Renal Hypertension

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Ver�nderung der reninaktivit�t und des blutdruckverhaltens im autologen nierentransplantationsmodell am hund bei modifikation der HTK-l�sung

Ludwig¹,

Isemer

Kallerhoff³

et al. 1995

Langenbecks Arch Chir

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Investigations of changes in activity of renin and blood pressure after reperfusion of the kidney transplant using HTK solution were carried out by means of an autologous, heterotopic model of kidney transplantation applied to dogs. Duration of cold ischemia was 48 h. According to variations in the composition of the HTK perfusion solution three test groups were set up. During the first 20 min after recirculation in each test group the renal venous and arterial renin activities were measured. Parallel to renin activity, the arterial blood pressure was recorded. During the first few minutes following recirculation of the kidney transplant the renin levels in the venous blood of the kidney were higher in test group 1 (HTK solution, perfusion height 120 cm) than in either of the other two, showing a median maximal increase of 195 ng/ml.h. In test group 2 the maximal venous renin concentration fell to 145 ng/ml.h, while graphs take a more uniform course. Test group 3 (HTK/tryptophan) differed from the others in having further improved renin values. After the 7.5 min of observation normal venous renin concentrations were measured following earlier values for maximal increase between 23.1 ng/ml.h and 120 ng/ml.h (median 61.5 ng/ml.h). The best reperfusion of the kidney was observed in the tryptophan group, albeit without any recognizable positive effects on the other renal functions. Initially low renin values do not necessarily correlate with a smooth postoperative renal function and vice versa. Initial renin values cannot provide a secure basis for predicting instant as well as long-term postoperative functions.(ABSTRACT TRUNCATED AT 250 WORDS)

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Plasma renin activity following renal transplantation

Cited by 3 publications

References 20 publications

The perioperative management of simultaneous bilateral nephrectomy with renal transplantation: a case series

The perioperative management of simultaneous bilateral nephrectomy with renal transplantation: a case series

Hypertension Following Renal Transplantation

Ver�nderung der reninaktivit�t und des blutdruckverhaltens im autologen nierentransplantationsmodell am hund bei modifikation der HTK-l�sung

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